Exercise and Arthritis, Prevention Measures

by Food and Drug Administration (FDA)

(Page 3 of 3)

Exercise and Arthritis

Proper exercises performed on a regular basis are an important part of arthritis treatment, according to the Arthritis Foundation. Twenty years ago, doctors advised exactly the opposite, fearing that activity would cause more damage and inflammation. Not exercising causes weak muscles, stiff joints, reduced mobility, and lost vitality, say rheumatologists, who now routinely advise a balance of physical activity and rest.

According to the 1996 Surgeon General's Report on Physical Activity and Health, regular, moderate physical activity is beneficial in decreasing fatigue, strengthening muscles and bones, increasing flexibility and stamina, and improving the general sense of well-being. The National Institutes of Health (NIH) advises that the amount and form of exercise should depend on which joints are involved, the amount of inflammation, how stable the joints are, and whether a joint replacement procedure has been done. A skilled physician who is knowledgeable about the medical and rehabilitation needs of people with arthritis, working with a physical therapist, can design an exercise plan for each patient.

Three main types of exercises are recommended:

Range-of-motion-moving a joint as far as it will comfortably go and then stretching it a little further to increase and maintain joint mobility, decrease pain, and improve joint function. These can be done daily, or at least every other day.

Strengthening-using muscles without moving joints to help increase muscle strength and stabilize weak joints. These can be done daily, or at least every other day, unless there is severe pain or swelling.

Endurance-aerobic exercises such as walking, swimming and bicycling to strengthen the heart and lungs and increase stamina. These should be done for 20 to 30 minutes, three times a week, unless there is severe pain or swelling.

Unproven Remedies

Many people with arthritis become discouraged with typical treatments because the disease progresses over time and the symptoms worsen. Consequently, they search for alternative therapies aimed at arthritis. But arthritis patients need to be careful because treatments not shown to be safe and effective through controlled scientific studies may be dangerous. According to the Arthritis Foundation, the benefits of a treatment in controlling arthritis should be greater than the risk of unwanted or harmful effects. Since arthritis symptoms may come and go, a person using an unproven remedy may mistakenly think the remedy worked simply because he or she tried it when symptoms were going into a natural remission.

Two controversial nutritional supplements, not approved by the FDA, have catapulted into the spotlight because of claims that they rebuild joint tissues damaged by osteoarthritis — or halt the disease entirely. But at this time, the use of glucosamine and chondroitin sulfate supplements warrant further in-depth studies on their safety and effectiveness, according to the Arthritis Foundation. The NIH plans to study the effectiveness of these supplements.

Both glucosamine and chondroitin sulfate occur in the body naturally and are vital to normal cartilage formation, but the Arthritis Foundation says there's no evidence that swallowed chondroitin is absorbed into the body and deposited into the joints. Moreover, no one knows how much glucosamine and chondroitin sulfate are in the bottles since current law does not require dietary supplements to be manufactured under the same good manufacturing practice standards as pharmaceuticals. As reported in the December 1999 UC Berkeley Wellness Letter, "It's a hit-or-miss proposition because there's no standardization and no guarantee that you're getting what the label says."

The Arthritis Foundation urges anyone considering using these supplements to become "fully educated about potential positive and negative effects." In addition, people are encouraged to consult their physicians about how the supplements fit within their existing treatment regimens. Above all, do not stop proven treatments and disease-management techniques in favor of the supplements.

The Arthritis Foundation also says that copper bracelets, mineral springs, vibrators, magnets, vinegar and honey, dimethyl sulfoxide, large doses of vitamins, drugs with hidden ingredients (such as steroids), and snake venom are all unproven remedies. And any unproven remedy, no matter how harmless, can become harmful if it stops or delays someone from seeking a prescribed treatment program from a knowledgeable physician.

Prevention Measures

There are ways to help prevent arthritis. Both CDC and the American College of Rheumatology recommend maintaining ideal weight, taking precautions to reduce repetitive joint use and injury on the job, avoiding sports injuries by performing warm-ups and strengthening exercises using weights, and by choosing appropriate sports equipment.

Lyme arthritis may develop after a bacterial infection is transmitted to humans through tick bites. To prevent this type of arthritis, health experts advise people to use insect repellents, wear long-sleeved shirts and pants while walking near wooded areas, and check for and remove ticks to help reduce the risk of getting the disease. CDC also recommends the prompt use of antibiotics for Lyme disease symptoms. In December 1998, FDA approved the first vaccine, Lymerix, to help prevent Lyme disease.

In an efficacy and safety trial, the vaccine's effectiveness in preventing Lyme disease was 49 percent after two injections and 76 percent after three. Vaccination should be considered by people 15 to 70 years old who live in or visit high-risk areas and have frequent or prolonged exposure to ticks. The vaccine has not yet been approved for use in children.

Hope for the Future

Recently approved drugs offer patients new options. For Jo Ellen Gluscevich, the results have not been so dramatic. She remains mostly housebound and must avoid crowds because her immune system is compromised and susceptible to infection. But as the population ages and arthritis becomes a growing problem, the Arthritis Foundation believes that "more physicians are recognizing the severity of the disease and the need for a broader approach toward treatment."

About the Author

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